急性桡骨头骨折合并桡尺远侧关节脱位的诊断和治疗  

Diagnosis and treatment of acute Essex-Lopresti injury

作　　者：鲁明[1] 曲巍[1] 张卫国[1] 吕德成[1] 

机构地区：[1]大连医科大学附属第一医院骨科,大连116011

出　　处：《中华手外科杂志》2011年第3期161-163,共3页Chinese Journal of Hand Surgery

摘　　要：目的研究急性桡骨头骨折合并桡尺远侧关节脱位（Essex—Lopresti损伤）的诊断和治疗特点。方法自2002年至2009年，我科共诊治了3例Essex-Lopresti损伤的患者。对桡骨头骨折进行固定修复或假体置换，对桡尺远侧关节损伤进行复位和内固定。对3例患者都进行了随访和疗效评估。结果经过15—48个月的随访，肘关节和腕关节评分系统评定显示术后所有患者的前臂功能恢复效果满意。结论急性Essex-Lopresti损伤的治疗原则是修复或假体置换桡骨头骨折，同时复位、固定桡尺远侧关节。如桡骨头骨折粉碎严重不能进行内固定，不可以行切除术，否则将导致严重后果。Objective To study tile methods of diagnose and treatment of acute radial head fracture accompanied by distal radioulnar joint dislocation （Essex-Lopresti injury）. Methods From 2002 to 2009, 3 patients with acute Essex-Lopresti injury were diagnosed and treated in our department. Radial head fractures were treated with fixation repair or radial head prosthesis replacement. Distal radioulnar joint dislocations were treated with reduction and fixation. All tilree patients were followed-up and the effects were assessed. Results Total time of follow-up ranged from 15 to 48 months. According to the elbow joint and wrist joint scoring systems, results of postoperative functions were satisfactory. Conclusion Acute Essex-Lopresti injuries should be treated with radial head fracture fixation or replacement, and simultaneous reduction and fixation of the dislocated distal radioulnar joint. When fracture of the radial head is too comminuted to be repaired, simple resection of the radial head is not an option since it will result in failure.

关 键 词：骨折 关节成形术 置换 脱位 ESSEX-LOPRESTI损伤 

分 类 号：R687.3[医药卫生—骨科学]